| NPI | 1295407161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015741) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL TBD) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2023-08-31 |